Saturday, September 17, 2011

Why are patients so unhappy when doctors tell them they do not know

Medicine is an inexact science and it's not always possible for the doctor to make the right diagnosis. This is especially true in patients with recurrent pregnancy loss, for example, where our technology is not good enough to pinpoint what the problem is.

However, when a doctor is truthful with his patient and tells her that we cannot pinpoint what the problem , is many patients get extremely upset and start questioning the doctor’s competence ( usually , they do this silently !). Patients want their doctors to be experts – someone who has all the answers. After all, it's very reassuring to know that you're in the safe hands of someone who can fix any problem you might have !

The irony is that it's only a very competent and confident doctor will tell the patient the truth, if he doesn't know what the diagnosis is. It takes a lot of courage for an expert to say – I don’t know ! Most doctors won't bother to take either the time or the energy to explain , and will just just a quick prescription - either for more tests ; or for “ treatment” ( which is no better than a placebo).

If your doctor tells you that he does not know what the diagnosis is, please don't get upset. In fact, you should admire the fact that he's willing to be forthright and honest and share information with you as an equal. Both of you are acknowledging that medicine does not always have all the answers. It's always better to know the truth so that you don't have to play dumb charades.

I'd also like to emphasize that just because we don't know what the diagnosis is does not always mean that we cannot offer treatment ! In fact, in reproductive medicine , our technology for being able to bypass problems is far better than our technology for being able to diagnose them accurately ! As I always tell my patients, I don't look for problems - I look for solutions . Solutions such as IVF allow us to successfully bypass problems without being able to identify these accurately.